title: The child and adolescent trichotillomania impact project: descriptive psychopathology, comorbidity, functional impairment, and treatment utilization.
abstract: OBJECTIVE
  Trichotillomania (TTM) is associated with significant morbidity, comorbidity, and functional impairment in adults. Despite the fact that TTM is typically a pediatric onset disorder, important questions remain about its phenomenology, comorbid symptoms, functional impact, and treatment utilization in youth. The current study was designed to provide an initial description of these factors using a convenience sample.
  
  
  METHODS
  An internet-based survey.
  
  
  RESULTS
  Surveys completed by 133 youth ages 10 to 17 were analyzed. Scalp hair was the most common pulling site, followed by eyelashes and eyebrows. The majority reported tension before pulling and gratification/relief immediately after pulling. Severity of anxiety and depressive symptoms were somewhat elevated, as measured by standard instruments, and correlated positively with the severity of TTM symptoms. Moderate impairment in social and academic functioning was reported. For those who had received treatment specifically for TTM, parent ratings indicated that few (17%) children and adolescents were either very much improved or much improved after intervention.
  
  
  CONCLUSIONS
  This study represents the largest survey of youth with TTM conducted thus far, and thus provides the most comprehensive description of TTM in youth to date.
  
  
  CONCLUSIONS
  Data was obtained from an anonymous, Internet-based sample, and thus may not be generalizable to all youth with TTM.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. marty@mail.med.upenn.edu
authors.forename: Martin E
authors.initials: ME
authors.lastname: Franklin
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Flessner
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Woods
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Keuthen
authors.forename: John C
authors.initials: JC
authors.lastname: Piacentini
authors.forename: Phoebe
authors.initials: P
authors.lastname: Moore
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Sara B
authors.initials: SB
authors.lastname: Cohen
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Wilson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000293:Adolescent; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001521:Behavior Therapy / Q000379:methods; D002648:Child; D003863:Depression / Q000209:etiology / Q000523:psychology; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D010361:Patients / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D012044:Regression Analysis; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014256:Trichotillomania / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*